# A client receiving gentamicin reports ringing in the ears, and the serum creatinine has increased. Which action should the nurse take before giving the next dose?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=397312&lang=en  
> language: en  
> subject: Medication Administration  
> category: PPT

## Question

A client receiving gentamicin reports ringing in the ears, and the serum creatinine has increased. Which action should the nurse take before giving the next dose?

## Option

1. Give the dose because tinnitus is expected with infection.
2. Hold the dose and notify the provider. **✔ Correct answer**
3. Administer the medication with grapefruit juice.
4. Request a prescription for a loop diuretic.

**Correct answer: 2**

## Explanation

Aminoglycosides can cause ototoxicity and nephrotoxicity. Tinnitus and rising creatinine are warning cues, so the nurse should hold the dose and notify the provider before administration. Giving the dose or adding nephrotoxic medications may worsen injury.

## In-depth explanation

Clinical Judgment
Use the client cues, timing, labs, and safety risks to select the response that best fits Gentamicin toxicity cues.

Memory Tip
Match the strongest cue cluster to the safest nursing judgment.

KR vs US
NCLEX items reward cue-based priority thinking rather than isolated recall.

## Clinical scenario

Clinical Practice Guide
For Gentamicin toxicity cues, compare the complete cue pattern with the client's current stability, ordered data, and expected nursing scope.

Caution
Do not choose an action from one isolated cue when the full scenario changes priority or safety.

## Key concepts

- **Aminoglycoside** — An antibiotic class associated with nephrotoxicity and ototoxicity.
- **Ototoxicity** — Medication-related injury to hearing or balance structures.
- **Serum Creatinine** — A laboratory marker used to evaluate kidney function.

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